牙齿漂白颜色稳定性影响因素研究进展

牙齿的漂白治疗可以改善变色牙齿的颜色,这种治疗方法越来越受到病人的欢迎,但是由于多种因素的影响,医生与病人均发现随着时间的变化,漂白后的牙齿颜色发生了反弹现象,该文就牙齿漂白颜色稳定性的影响因素做一综述。     

激光牙齿漂白副作用的研究进展

牙齿漂白能使牙着色患者获得较好的美观效果,其主要原理是过氧化物渗透入牙釉质和牙本质后发生的氧化还原反应。激光具有光谱窄、能量高的特点,可加热漂白凝胶,加快漂白进程,并降低牙本质通透性,减少牙本质过敏现象,因而激光牙齿漂白应用前景广阔,但同时它可能产生牙髓温度升高、牙釉质表面改变等副作用。本文就激光应用于牙齿漂白治疗可能导致的副作用做一综述。     

激光牙齿漂白术中配合体会

目的本文的目的在于探讨用精确、细致的方法共同完成激光牙齿漂白术的过程，探讨减少和消除因配合不良引起的症状。方法从术前准备、术中各项配合、术后护理的各阶段进行了归纳，重点突出地表现了术前心理准备，术中配合橡皮障使用、激光机安全与维护，术后色素预防方法。结果激光牙齿票白对多种牙齿染色的治疗效果良好，熟练的、细致的配合可以大大地减少并发症的发生。结论激光牙齿漂白术的医生、助手的配合质量与术后患者的痛苦、疗效、疗效维持有密切关系。     

外伤性牙齿变色行髓腔内漂白术后2年疗效观察及影响因素分析

目的:对因外伤导致的牙齿变色患牙行髓腔内漂白术后的效果进行2年的临床观察,并对影响因素进行分析.方法:对行髓腔内漂白术的40例牙外伤患者共49颗患牙进行2年的随访观察,使用Cox比例风险回归模型对可能影响治疗效果的因素进行分析.结果:在2年的观察期内,髓腔内漂白治疗的成功率为80.7％.Cox回归分析的结果显示,患者在...     

髓腔内漂白对牙周组织损伤的研究

牙齿内漂白治疗最常用的漂白剂是３０％过氧化氢水溶液。漂白反应时，它可经牙本上管渗出，引起牙周组织损伤。本实验应用透射电镜、光镜观察了狗牙齿内漂白后龈组织的结构发迹结果表明：随漂白时间延长，电镜及光镜标本观察到牙龈组织损伤逐渐加重，主要表现为细胞水肿，线粒体肿胀，内质网扩张，细胞内出现脂滴，炎细胞浸润等。     

活髓牙漂白引起牙齿敏感的研究进展

漂白引起的牙齿敏感(BS)是活髓牙漂白最常见的不良反应,影响了患者接受漂白治疗的舒适度和满意度,也增加了临床对活髓漂白治疗安全性的担忧.本文旨在从BS的临床特点、病因学理论、可能的影响因素和防治措施作一综述.     

二极管激光应用3种治疗方案进行牙齿漂白的有效性和持续性

问题；很多研究评估了牙齿漂白的有效性．但很少有学者针对6个月后随访时牙齿变色情况进行研究。目的：研究评估用激光应用不同治疗方案进行牙齿漂白的有效性和6个月后牙齿变色的情况。方法和材料：将60个患者平均分为3组．用含有34％过氧化氢的二极管激光进行牙齿漂白。第一组患者进行1次激光牙齿漂白。第二组：患者进行2次激光牙齿漂白．时间间隔为1周。第三组：和第二组进行同样处理，然后每个月进行1次家庭漂白．持续3个月。评估牙齿颜色4次漂白前．漂白结束即刻．漂白后3个月，以及漂白后6个月。结果：在6个月内所有牙齿都有明显的颜色变化。牙齿颜色反弹最少的是第三组，其次分别是第二组和第一组。结论：进行2次诊室激光漂白（每次间隔1周）后进行每个月1次家庭漂白，共持续3个月的方案的漂白效果更具有持久性。临床意义：相对于只用诊室漂白的治疗方案．采用过氧化氢辅助的诊室1周2次诊室激光漂白（每次间隔1周）．结合3个月中每个月1次家庭漂白的联合方案，是6个月后牙齿颜色反弹最少的有效方案。     

牙齿漂白及其对正畸托槽粘接强度的影响

随着人们对牙齿美观追求的日益增高,牙齿漂白作为牙变色的常规治疗方法已被大多数患者所接受,同时,牙齿漂白的流行也对口腔医学产生了重大的影响。不少正畸患者曾接受过牙齿漂白的治疗,而正畸托槽与釉质表面直接粘接,故牙齿漂白对釉质表面形态以及树脂与釉质粘接强度的影响值得正畸医生关注。本文就牙齿漂白对正畸托槽粘接强度的影响作一综述。     

低浓度家庭漂白系统的临床应用效果评价

目的:探讨分析10%Opalescence PF漂白系统在天然牙牙齿漂白中的临床效果。方法:选取西安交通大学口腔医院2017～2021年间40例进行牙齿漂白的患者作为研究对象。采用10%Opalescence PF漂白系统进行牙齿漂白，2周后利用Vita easyshade advance电子比色仪对漂白效果进行评价，并进行牙齿敏感度及患者满意度VAS量化分析。结果:40例患者经2周漂白后已行漂白治疗的牙齿颜色色阶均有显著提升(P<0.05),有效率为100%。漂白前后牙齿敏感度无统计学差异(P>0.05),且均表现为轻度敏感，患者对漂白效果满意度为100%,患者满意度与牙齿敏感性无相关性(P>0.05)。结论:10%Opalescence PF漂白系统在天然牙牙齿漂白中有显著效果。     

激光在牙齿漂白中的应用现状

激光牙齿漂白作为一种新型的牙齿漂白方法,具有快速、安全、有效等优点,受到国内外广泛关注。文章就应用于牙齿漂白的激光种类及激光牙齿漂白的原理、适应证、与其他光源漂白的区别、对牙齿表面结构的影响、效果、安全性、过程中光敏剂的应用等做一介绍。     

冷光牙齿漂白技术对活髓牙牙髓影响的病理观察

目的 探讨冷光牙齿漂白技术对活髓牙牙髓的影响.方法 选择因正畸需要拔除的40颗活髓牙,对照组(10颗)不做任何处理拔除,其余30颗牙采用冷光漂白后分别即刻拔除(15颗)和漂白7 d后拔除(15颗).40颗牙齿均制作病理切片,镜下观察牙髓组织形态.结果 所有活髓牙漂白前后均未发现有任何临床症状.漂白后即刻拔除组、7 d后拔除组以及对照组在镜下均表现为正常的牙髓组织结构,与对照组相比漂白后即刻拔除组及7 d后拔除组牙髓组织均无明显改变.结论 冷光牙齿漂白技术对活髓牙牙髓无明显不良影响,是一项安全可靠的漂白技术.     

The effects of polishing and bleaching on the colour of discoloured teeth in vivo

Bleaching is an effective method for restoring the colour of discoloured vital teeth. Power bleaching, in particular, in which a bleaching solution containing 35% hydrogen peroxide is activated by a strong light source using a plasma arc, makes it possible to bleach teeth effectively in a short time. The purpose of this study was to determine how polishing or power bleaching the tooth surface affects tooth colour. The subjects selected were patients who had slightly discoloured teeth. The colour of precisely identified sites on six anterior teeth was measured before treatment, after polishing and after bleaching, to ascertain changes in colour. The measurements revealed that tooth colour changes slightly after polishing, but it shows a much greater change after bleaching, and that the post-bleaching change in tooth colour was caused both by elevation of lightness and reduction of yellowness. They also revealed that the colour difference between pre-treatment and post-bleaching does not depend on the type of tooth. These results suggested that power bleaching is an effective technique for improving slightly discoloured vital teeth, regardless of the type of tooth.     

影响牙齿美白效果的因素

牙齿美白技术在口腔临床诊疗中的应用日益广泛,以漂白技术为主的非侵入性牙齿美白因其独特的不破坏牙体硬组织的优越性,成为许多牙齿着色患者的选择。不同类型着色牙能达到的美白效果不一样,其中四环素牙的漂白疗效不及氟斑牙。过氧化氢漂白剂与含同等浓度过氧化氢的过氧化脲漂白剂的漂白效果接近,而在过氧化物漂白剂中加入诸如菠萝蛋白酶等无过氧化物试剂能提高牙齿美白效果;低浓度的漂白剂延长作用时间能达到高浓度漂白剂的牙齿美白效果。目前pH值对牙齿美白效果的影响仍存有争议;激光与传统的过氧化物漂白剂结合能有效提高牙齿美白效果;联合牙釉质微研磨与过氧化物牙齿漂白剂能使氟斑牙的美白效果更佳。本综述通过分析牙齿着色原因、漂白剂的性质、激光微研磨的应用及漂白后牙齿组织的改变探讨以漂白技术为主的非侵入性牙齿美白效果的影响因素。     

Micro-structural integrity of dental enamel subjected to two tooth whitening regimes

Colour modification of tooth enamel has proven successful, but it is unclear how various bleaching applications affect micro-structural integrity of the whitened enamel. To investigate the internal structural integrity of human intact tooth enamel with the application of two commonly used whitening regimes (in-office power bleaching with 35% hydrogen peroxide and home bleaching with 10% carbamide peroxide), evaluations were performed on teeth of identical colour classification. After the bleaching applications, the enamel mineral density was quantified and visualised with micro-computed tomography. The micro-structural differences between the whitened tooth enamel samples were distinctive, though the colour parameter changes within the samples were equivalent. Home bleaching achieved colour modification by demineralisation, whereas in-office bleaching depended on redistribution of the minerals after treatment and subsequent enhanced mineralisation.     

活髓牙冷光美白临床效果评价

目的    探讨活髓牙冷光美白的临床效果。方法    选择2011年8月至2014年8月在上海交通大学医学院附属第九人民医院口腔修复科接受Beyond冷光美白治疗的患者206例,按着色原因分为氟斑牙、四环素牙、外源性着色及其他原因4组。用视觉评价法和比色仪法评价漂白对牙色的影响,并追踪漂白后24 h、1周及3个月的牙色反弹情况。用视觉模拟评分法评价漂白完成即刻、漂白后24 h和1周牙敏感度的变化。结果    牙色评价中除四环素牙效果略差外,其他类型的着色牙漂白均有显著效果,且在追踪的3个月内未发现明显的反弹现象。牙漂白后的敏感多出现在漂白后24 h内。除氟斑牙外,其余类型着色牙的敏感程度在漂白24 h后即与漂白前差异无统计学意义（P > 0.05）;氟斑牙在漂白后1周可恢复至漂白前敏感程度。结论    冷光美白用于临床活髓牙漂白可取得基本稳定、满意的效果。     

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??Objective    To evaluate the clinical effectiveness of a light-activated bleaching system on vital teeth. Methods    Two hundred and six cases bleached by ‘Beyond’ light-activated bleaching system during three years were included in the study to evaluate the effectiveness. All the cases were divided into four groups??dental fluorosis??tetracycline stained teeth??extrinsic stained teeth and others. Visual determination of shade and spectrophotometer were used to measure the tooth discoloration immediately after bleaching. After twenty-four hours??one week and three months of follow-up??assess the rebound of color. Assessment of tooth sensitivity was carried out by visual analogue scale immediately??twenty four hours and one week after bleaching. Results    Satisfactory effectiveness was achieved in all groups except the group of tetracycline stained teeth. No obvious rebound of color was observed in the period of three months. Tooth sensitivity only occurred within twenty hours after bleaching. Except in the group of dental fluorosis??after 24 hours of bleaching tooth sensitivity in other groups had no difference ??P > 0.05?? compared with that before bleaching. The level of tooth sensitivity in group of dental fluorosis also recovered within one week. Conclusion    Stable and satisfactory effectiveness can be achieved in vital tooth bleaching by light-activated bleaching system.     

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目的评价家庭夜间美白法与冷光美白技术用于着色牙漂白的临床效果。方法收集广州市东升医院口腔科2007--2010年的96例着色牙病例,分别用家庭夜间美白法（50例）与冷光美白技术（46例）进行牙齿漂白,以VITA比色板分析脱色效果,用数字化疼痛评判法（VAS）记录受试者术中牙齿敏感程度。术后及2年后复查评价疗效。结果术后家庭夜间美白组总有效率为98．0％,冷光美白组为100．0％,两组总有效率差异无统计学意义（P〉0．05）。四环素牙治疗显效率、总有效率方面：家庭夜间美白组为72．2％、94．4％,冷光美白纽为90．0％、100．0％,差异均有统计学意义（均P〈0．05）。术中VAS评判：家庭夜间美白组敏感率为84．0％,冷光美白组为80．4％,两组敏感率差异无统计学意义（P〉0．05）。所有敏感者停止用药后6～24h均能缓解。2年后复查：两组牙齿颜色均出现反色。家庭夜间美白组总有效率为32．0％,冷光美白组为28-3％,两组差异无统计学意义（P〉0．05）;与治疗结束时的总有效率差异有统计学意义（P〈0．05）。2年后检查两组牙髓活力均正常。结论家庭夜间美白法与冷光美白技术治疗着色牙效果显著,在四环素牙上冷光美白技术优于家庭夜间美白法。2年后两组牙颜色均出现反色。两种漂白方法均具有临床安全性。     

Influence of in Situ Postbleaching Times on Shear Bond Strength of Resin-Based Composite Restorations

BackgroundThe authors conducted an in situ study of the influence of various time intervals after tooth bleaching with 35 percent hydrogen peroxide on the bond strength of resin-based composite restorations.MethodsAfter selecting 20 participants, the authors randomly fixed enamel and dentin blocks onto the buccal surfaces of posterior maxillary teeth one week before performing tooth bleaching with 35 percent hydrogen peroxide. After the bleaching treatment, they removed one block of dentin or enamel and prepared it for the bond strength tests according to these time intervals: no bleaching treatment (controls), immediately after bleaching, seven days after bleaching, 14 days after bleaching and 21 days after bleaching.ResultsThe analysis of variance and Tukey test showed significant differences between times (P < .05), and shear bond strength values of resin-based composite to enamel and dentin were lower immediately after the bleaching treatment.ConclusionsThe authors found that 35 percent hydrogen peroxide reduces the bond strength to enamel and dentin and that it is necessary to wait seven days before performing adhesive restorative procedures.Clinical ImplicationsThe results of this study suggest that clinicians should allow seven days to elapse after completion of in-office bleaching with 35 percent hydrogen peroxide before placing adhesive restorations.     

一种实用的牙齿漂白技术

将国际公认的牙齿漂白药物过氧化脲加入无毒高分子成膜剂配成胶状液 ,涂于干燥牙面1— 2分钟形成附着于牙面的薄膜 ,可维持 1小时以上。此期间过氧化脲分解释放新生氧而将牙齿漂白。临床研究表明 :牙齿增白涂膜是一种安全、有效、实用的漂白牙齿方法。本产品已获中国专利 (专利号 :96 1186 0 5.4 ,PCT/ CN97/ 0 0 0 0 4 )